Reed NS et al. - In a study to determine the role of post-operative radiation in the management of uterine sarcomas, it seems that prognostic factor analysis shows that stage, age, and histological subtype are important predictors of behaviour, which may explain differences between carcinosarcomas (CS) and leiomyosarcomas (LMS). CS appears to show more kinship to poorly differentiated endometrial carcinomas in behaviour Methods
The study accrued 224 pts; all uterine sarcoma subtypes were permitted
Pts were required to have undergone as a minimum, TAH and BSO washings (166 pts) but nodal sampling was optional
There were 103 LMS, 91 CS, and 28 endometrial stromal sarcomas (ESS)
Pts were randomised to either observation or pelvic radiation, 51 Gy in 28 fractions over 5 weeks
Results
112 were recruited to each arm
The initial analysis has shown a reduction in local relapse (14 vs 24) but no effect on either OS or PFS
No unexpected toxicity was seen in the radiation arm
No difference in either overall or disease-free survival was demonstrated but there is an increased local control for CS pts receiving radiation but without any benefit for LMS
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